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Subarachnoid hemorrhage randomized

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https://www.readbyqxmd.com/read/29456646/an-experimental-rabbit-model-of-symptomatic-cerebral-vasospasm-with-in-vivo-neuroimaging-assessment-and-ex-vivo-histological-validation
#1
Yunchang Mo, Luping Huang, Linbi Chen, Michael Veronesi, Yiyi Shi, Sijia Chen, Linli Peng, Leping Zhou, Yonglin Pu, Junlu Wang
Cerebral vasospasm (CVS) is a severe complication that occurs following aneurysmal subarachnoid hemorrhage (SAH). Magnetic resonance angiography (MRA) has been used to evaluate brain injury following SAH in humans. The present study was designed to assess a rabbit model of symptomatic CVS (SCVS) and the utility of MRA in evaluating SCVS in rabbits. Japanese white rabbits (n=24) were randomly divided into 2 equal groups: A sham group and a SAH group. Neurological scores were evaluated for 7 days following SAH...
March 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29425980/dose-dependent-effects-of-statins-for-patients-with-aneurysmal-subarachnoid-hemorrhage-meta-regression-analysis
#2
REVIEW
Minh-Son To, Shivesh Prakash, Santosh I Poonnoose, Shailesh Bihari
OBJECTIVE: The study utilizes meta-regression analysis to quantify the dose-dependent effects of statin pharmacotherapy on vasospasm, delayed ischemic neurologic deficits (DINDs) and mortality in aneurysmal subarachnoid hemorrhage (aSAH). METHODS: Prospective, retrospective observational studies and randomized controlled trials (RCTs) were retrieved by a systematic database search. Summary estimates were expressed as absolute risk (AR) for a given statin dose or control (placebo)...
February 6, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29406421/outcomes-and-costs-of-patients-admitted-to-the-icu-due-to-spontaneous-intracranial-hemorrhage
#3
Shannon M Fernando, Peter M Reardon, Dar Dowlatshahi, Shane W English, Kednapa Thavorn, Peter Tanuseputro, Jeffrey J Perry, Erin Rosenberg, Eelco F Wijdicks, Daren K Heyland, Kwadwo Kyeremanteng
OBJECTIVES: Spontaneous intracranial hemorrhage, including subarachnoid hemorrhage and intracerebral hemorrhage, is associated with significant morbidity and mortality. Although many of these patients will require ICU admission, little is known regarding their outcomes and the costs incurred. We evaluated this population in order to identify outcomes and cost patterns. DESIGN: Retrospective cohort analysis of a health administrative database. SETTING: Two ICUs within a single hospital system...
February 5, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29372929/gamma-glutamyl-transferase-predicts-future-stroke-a-korean-nationwide-study
#4
Wookjin Yang, Chi Kyung Kim, Do Yeon Kim, Han-Gil Jeong, Seung-Hoon Lee
OBJECTIVE: Although gamma-glutamyl transferase (GGT) is generally regarded as an alternative biomarker for alcohol consumption, its independent role in vascular diseases emerged recently. However, its role in stroke remains unknown. The aim of this study is to clarify the impact of GGT on stroke in a large-sized, national, standardized population cohort in Korea. METHODS: In Korea, the National Health Insurance Service (NHIS) provides full-coverage health insurance service for all citizens...
January 25, 2018: Annals of Neurology
https://www.readbyqxmd.com/read/29350603/decision-tree-analysis-in-subarachnoid-hemorrhage-prediction-of-outcome-parameters-during-the-course-of-aneurysmal-subarachnoid-hemorrhage-using-decision-tree-analysis
#5
Isabel Charlotte Hostettler, Carl Muroi, Johannes Konstantin Richter, Josef Schmid, Marian Christoph Neidert, Martin Seule, Oliver Boss, Athina Pangalu, Menno Robbert Germans, Emanuela Keller
OBJECTIVE The aim of this study was to create prediction models for outcome parameters by decision tree analysis based on clinical and laboratory data in patients with aneurysmal subarachnoid hemorrhage (aSAH). METHODS The database consisted of clinical and laboratory parameters of 548 patients with aSAH who were admitted to the Neurocritical Care Unit, University Hospital Zurich. To examine the model performance, the cohort was randomly divided into a derivation cohort (60% [n = 329]; training data set) and a validation cohort (40% [n = 219]; test data set)...
January 19, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29330661/adipose-tissue-fatty-acids-present-in-dairy-fat-and-risk-of-stroke-the-danish-diet-cancer-and-health-cohort
#6
Anne Sofie Dam Laursen, Christina Catherine Dahm, Søren Paaske Johnsen, Erik Berg Schmidt, Kim Overvad, Marianne Uhre Jakobsen
PURPOSE: The role of dairy fat for the risk of stroke is not yet clear. Adipose tissue reflects long-term fatty acid intake and metabolism. We, therefore, investigated associations for percentages of adipose tissue fatty acids, for which dairy products are a major source (12:0, 14:0, 14:1 cis-9, 15:0, 17:0, 18:1 trans-11 and 18:2 cis-9, trans-11), with incident total stroke and stroke subtypes. METHODS: We conducted a case-cohort study within the Danish Diet, Cancer and Health cohort, including all incident stroke cases (n = 2108) and a random sample of the total cohort (n = 3186)...
January 12, 2018: European Journal of Nutrition
https://www.readbyqxmd.com/read/29323183/delivery-of-xenon-containing-echogenic-liposomes-inhibits-early-brain-injury-following-subarachnoid-hemorrhage
#7
Yi-Feng Miao, Tao Peng, Melanie R Moody, Melvin E Klegerman, Jaroslaw Aronowski, James Grotta, David D McPherson, Hyunggun Kim, Shao-Ling Huang
Xenon (Xe), a noble gas, has promising neuroprotective properties with no proven adverse side-effects. We evaluated neuroprotective effects of Xe delivered by Xe-containing echogenic liposomes (Xe-ELIP) via ultrasound-controlled cerebral drug release on early brain injury following subarachnoid hemorrhage (SAH). The Xe-ELIP structure was evaluated by ultrasound imaging, electron microscopy and gas chromatography-mass spectroscopy. Animals were randomly divided into five groups: Sham, SAH, SAH treated with Xe-ELIP, empty ELIP, or Xe-saturated saline...
January 11, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29243978/reduction-of-shunt-dependency-rates-following-aneurysmal-subarachnoid-hemorrhage-by-tandem-fenestration-of-the-lamina-terminalis-and-membrane-of-liliequist-during-microsurgical-aneurysm-repair
#8
Ethan A Winkler, Jan-Karl Burkhardt, W Caleb Rutledge, Jonathan W Rick, Carlene P Partow, John K Yue, Harjus Birk, Ashley M Bach, Kunal P Raygor, Michael T Lawton
OBJECTIVE Shunt-dependent hydrocephalus is an important cause of morbidity following aneurysmal subarachnoid hemorrhage (aSAH) in excess of 20% of cases. Hydrocephalus leads to prolonged hospital and ICU stays, well as to repeated surgical interventions, readmissions, and complications associated with ventriculoperitoneal (VP) shunts, including shunt failure and infection. Whether variations in surgical technique at the time of aneurysm treatment may modify rates of shunt dependency remains a matter of debate...
December 15, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29212462/pharmacological-targeting-of-secondary-brain-damage-following-ischemic-or-hemorrhagic-stroke-traumatic-brain-injury-and-bacterial-meningitis-a-systematic-review-and-meta-analysis
#9
Thomas Beez, Hans-Jakob Steiger, Nima Etminan
BACKGROUND: The effectiveness of pharmacological strategies exclusively targeting secondary brain damage (SBD) following ischemic stroke, aneurysmal subarachnoid hemorrhage, aSAH, intracerebral hemorrhage (ICH), traumatic brain injury (TBI) and bacterial meningitis is unclear. This meta-analysis studied the effect of SBD targeted treatment on clinical outcome across the pathological entities. METHODS: Randomized, controlled, double-blinded trials on aforementioned entities with 'death' as endpoint were identified...
December 7, 2017: BMC Neurology
https://www.readbyqxmd.com/read/29171362/complications-of-endovascular-treatment-for-acute-ischemic-stroke-prevention-and-management
#10
Joyce S Balami, Philip M White, Peter J McMeekin, Gary A Ford, Alastair M Buchan
Endovascular mechanical thrombectomy (MT) for the treatment of acute stroke due to large vessel occlusion has evolved significantly with the publication of multiple positive thrombectomy trials. MT is now a recommended treatment for acute ischemic stroke. Mechanical thrombectomy is associated with a number of intra-procedural or post-operative complications, which need to be minimized and effectively managed to maximize the benefits of thrombectomy. Procedural complications include: access-site problems (vessel/nerve injury, access-site hematoma and groin infection); device-related complications (vasospasm, arterial perforation and dissection, device detachment/misplacement); symptomatic intracerebral hemorrhage; subarachnoid hemorrhage; embolization to new or target vessel territory...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29159600/early-seizure-prophylaxis-in-traumatic-brain-injuries-revisited-a-prospective-observational-study
#11
Desmond Khor, Jinglan Wu, Quanqiu Hong, Elizabeth Benjamin, Shuiming Xiao, Kenji Inaba, Demetrios Demetriades
INTRODUCTION: Pharmacological prophylaxis for early seizures following traumatic brain injury (TBI) is a recommendation in the Brain Trauma Foundation Guidelines. However, several studies have challenged the efficacy and safety of this practice, resulting in varied practice across centers around the world. The purpose of the present study was to compare the incidence of early clinical seizures following TBI, between two large centers, a US Center that practises routine seizure prophylaxis and a Chinese Center that does not use seizure prophylaxis following TBI...
November 20, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29158449/induced-hypertension-for-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage-a-randomized-clinical-trial
#12
Celine S Gathier, Walter M van den Bergh, Mathieu van der Jagt, Bon H Verweij, Jan Willem Dankbaar, Marcella C Müller, Annemarie W Oldenbeuving, Gabriel J E Rinkel, Arjen J C Slooter
BACKGROUND AND PURPOSE: Induced hypertension is widely used to treat delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage, but a literature review shows that its presumed effectiveness is based on uncontrolled case-series only. We here report clinical outcome of aneurysmal subarachnoid hemorrhage patients with DCI included in a randomized trial on the effectiveness of induced hypertension. METHODS: Aneurysmal subarachnoid hemorrhage patients with clinical symptoms of DCI were randomized to induced hypertension or no induced hypertension...
January 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29093065/low-dose-aspirin-and-risk-of-intracranial-bleeds-an-observational-study-in-uk-general-practice
#13
Lucía Cea Soriano, David Gaist, Montse Soriano-Gabarró, Susan Bromley, Luis A García Rodríguez
OBJECTIVE: To quantify the risk of intracranial bleeds (ICBs) associated with new use of prophylactic low-dose aspirin using a population-based primary care database in the United Kingdom. METHODS: A cohort of new users of low-dose aspirin (75-300 mg; n = 199,079) aged 40-84 years and a 1:1 matched cohort of nonusers of low-dose aspirin at baseline were followed (maximum 14 years, median 5.4 years) to identify incident cases of ICB, with validation by manual review of patient records or linkage to hospitalization data...
November 28, 2017: Neurology
https://www.readbyqxmd.com/read/29048544/valproic-acid-attenuates-the-risk-of-acute-respiratory-failure-in-patients-with-subarachnoid-hemorrhage
#14
Wen-I Liao, Wu-Chien Chien, Chi-Hsiang Chung, Jen-Chun Wang, Tzu-Tsao Chung, Shi-Jye Chu, Shih-Hung Tsai
Background: To determine whether the use of valproic acid (VPA) is associated with a decreased risk of acute respiratory failure (ARF) in patients with subarachnoid hemorrhage (SAH). Methods: The Taiwan National Health Insurance Research Database was used to analyze all patients newly diagnosed with SAH from 2000 to 2010. The VPA users were matched for age, gender and index date in 1:2 ratios with randomly selected non-VPA users as a comparison group. Multivariate Cox regression was used to identify the predictors of ARF and to compare the incidence rates of ARF among SAH patients using and not using VPA...
October 18, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/29031080/endovascular-therapy-for-vasospasm-secondary-to-subarachnoid-hemorrhage-a-meta-analysis-and-systematic-review
#15
REVIEW
Zhong Yao, Xin Hu, Chao You
Endovascular therapy has been used as an alternative treatment for vasospasm following subarachnoid hemorrhage. The effectiveness and safety of endovascular therapy are still controversial. We performed a systematic review and meta-analysis to identify any advantage of endovascular therapy over traditional medical treatment. We systematically reviewed related English publications by searching PubMed, Ovid, Cochrane library, and Web of Science up to May 2017.The risk ratios (RR) and 95% confidence intervals (CI) were synthesized with fixed effect model...
December 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29021779/xenon-reduces-neuronal-hippocampal-damage-and-alters-the-pattern-of-microglial-activation-after-experimental-subarachnoid-hemorrhage-a-randomized-controlled-animal-trial
#16
Michael Veldeman, Mark Coburn, Rolf Rossaint, Hans Clusmann, Kay Nolte, Benedikt Kremer, Anke Höllig
OBJECTIVE: The neuroprotective properties of the noble gas xenon have already been demonstrated using a variety of injury models. Here, we examine for the first time xenon's possible effect in attenuating early brain injury (EBI) and its influence on posthemorrhagic microglial neuroinflammation in an in vivo rat model of subarachnoid hemorrhage (SAH). METHODS: Sprague-Dawley rats (n = 22) were randomly assigned to receive either Sham surgery (n = 9; divided into two groups) or SAH induction via endovascular perforation (n = 13, divided into two groups)...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28989143/-protective-effect-of-mitochondria-targeted-antioxidant-ss31-on-early-brain-injury-following-subarachnoid-hemorrhage-in-rats
#17
Jian Zhou, Zhengzheng Li, Zhenggang Chen, Kun Yang
To evaluate protective effects of SS31 on early brain injury (EBI) induced by subarachnoid hemorrhage (SAH) in rats.
 Methods: A total of 96 Sprague-Dawley rats were randomly divided into 4 groups: A sham group, an SAH group, an SAH+vehicle group (SAH+V), and an SAH+SS31 group. The SAH-induced prechiasmatic cistern rat model was established in this study. Neurological deficit scores were evaluated at 24 h after SAH. The SS31 (5 mg/kg) as well as equal volume of vehicle were administrated intraperitoneally at 2 h after SAH...
September 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28987848/prevention-and-treatment-for-hyponatremia-in-patients-with-subarachnoid-hemorrhage-a-systematic-review
#18
REVIEW
Kieran Shah, Ricky Turgeon, Peter A Gooderham, Mary H H Ensom
BACKGROUND: Current guidelines for the management of hyponatremia in patients with subarachnoid hemorrhage (SAH) are not based on a systematic assessment of the literature. We evaluated published studies on the efficacy and safety of current preventative and treatment strategies for hyponatremia in patients with SAH. METHODS: We searched the Cochrane Central Register of Controlled Trials, Embase, MEDLINE, and PubMed for relevant studies. Primary outcomes of interest included neurologic functional outcomes, symptomatic vasospasm, and others...
October 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28973585/characteristics-of-unruptured-compared-to-ruptured-intracranial-aneurysms-a-multicenter-case-control-study
#19
Isabel C Hostettler, Varinder S Alg, Nichole Shahi, Fatima Jichi, Stephen Bonner, Daniel Walsh, Diederik Bulters, Neil Kitchen, Martin M Brown, Henry Houlden, Joan Grieve, David J Werring
BACKGROUND: Only a minority of intracranial aneurysms rupture to cause subarachnoid hemorrhage. OBJECTIVE: To test the hypothesis that unruptured aneurysms have different characteristics and risk factor profiles compared to ruptured aneurysms. METHODS: We recruited patients with unruptured aneurysms or aneurysmal subarachnoid hemorrhages at 22 UK hospitals between 2011 and 2014. Demographic, clinical, and imaging data were collected using standardized case report forms...
July 25, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28966073/effect-of-simvastatin-in-patients-with-aneurysmal-subarachnoid-hemorrhage-a-systematic-review-and-meta-analysis
#20
REVIEW
Hongju Liu, Xiaoli Xu
BACKGROUND: Simvastatin might be beneficial to the patients with aneurysmal subarachnoid hemorrhage. However, the results remained controversial. We conducted a systematic review and meta-analysis to explore the efficacy of simvastatin for aneurysmal subarachnoid hemorrhage. METHODS: PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of simvastatin versus placebo on aneurysmal subarachnoid hemorrhage were included...
September 5, 2017: American Journal of Emergency Medicine
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